African swine fever: A review of cleaning and disinfection procedures in commercial pig holdings.

African swine fever (ASF) is one of the most important diseases in pigs. Since there are no effective vaccines against the virus, farm biosecurity and good farming practices are the only effective tools to prevent the spread of the ASF virus (ASFV) in pig holdings. Hence, an important component of farm biosecurity is the Cleaning and Disinfection (C&D) procedure. Precise indications regarding the ideal disinfectant against ASFV are lacking, but every country has approved and/or authorized a list of biocides effective against ASFV. Lipidic solvents, which destroy the envelope of the virus and commercial disinfectants based on iodine and phenolic compounds are effective in inactivating the ASFV. This review describes the C&D protocol to apply in pig holdings with particular reference to ASFV.

[Vascular thrombosis and pulmonary thrombo-embolism due to harness suspension]. / Attività fisica con utilizzo di imbracatura in sospensione su funi e trombosi vasale.

BACKGROUND: In many sports (such as rock-climbing and caving) and working activities (e.g., construction and maintenance of buildings, pruning of lung-trunked trees, abseiling in wells) people run the risk of falling from a height. To prevent the effects of any potential fall, personalprotection devices consisting of at least a body holding device (i.e. a harness of some type), a lanyard and a reliable anchor are used. OBJECTIVES: Reporting on the occurrence of vascular thrombosis in subjects undergoing prolonged hanging in a harness, either for work or recreation. METHODS: We investigated patients treated for vascular thrombosis in our hospital in the last 5 years to identify subjects with frequent use of a harness. RESULTS: We identified a 36-year-old rock-climber who developed pulmonary thrombo-embolism and infarction 5 days after he had been wearing a harness for 12 hours consecutively, and a 32 year-old worker who often used a harness to fix wire-nettings to prevent rocks falling from steep places and suffered thrombosis of the left superficial femoral artery. A feature of both cases was the considerable length of time spent hanging in the harness and the absence of alternative risk factors for thrombosis. CONCLUSIONS: Prolonged hanging in a harness can be dangerous in itself because it can produce vascular thrombosis. Reduction of intravascular blood flow (stasis) and compression of the femoral veins by harness groin straps were the likely pathogenetic mechanisms of the described diseases. The importance is stressed of prevention, which must be based on planned regular breaks in the hanging position, checking on the fit and comfort level of the harness before it is first used, as well as medical surveillance of the subjects who spend prolonged periods in a harness for work or recreation.

Hypokalemic nephropathy in an adult patient with partial empty sella: a classic Bartter's syndrome, a Gitelman's syndrome or both?

Bartter's syndrome belongs to a group of hypokalemic renal channel diseases. These channels are located in the lipid layer of cell membranes where they exist as water channels through which ion transport is performed. Based on the type of genetic disorder and clinical presentation, Bartter's syndrome is classified as neonatal, classical and Gitelman's syndrome. Most of the cases have been noted in pediatric age groups and adult-onset cases are very rare. Moreover, an association between Bartter's syndrome and empty sella has recently been reported in 3 children. We report here the second case of an adult patient affected by Bartter's syndrome with partial empty sella. The patient showed some clinical and histological characteristics of both classic Bartter's syndrome and Gitelman's syndrome, suggesting that genotype and phenotype of Bartter's syndrome are not so clear-cut and that phenotypic overlap may occur, according to a recent hypothesis. Magnetic resonance imaging disclosed a partial empty sella. A thorough endocrinological investigation showed normal hypophyseal, thyroidal, adrenal and gonadal function. Good therapeutic effects were achieved using spironolactone, ACE-inhibitor and potassium supplementation, with normalization of the kalemia. At present, the value of the association of Bartter's syndrome and empty sella remains unclear and future studies are needed to clarify the importance of this association, both in children and in adult patients affected by Bartter's syndrome.

Psychological support counselling improves gluten-free diet compliance in coeliac patients with affective disorders.

BACKGROUND: Anxiety and depression are common features of coeliac disease. Depression is cause of non-compliance to treatment in chronic illness. AIM: To evaluate the useful of psychological support counselling to improve affective disorders and gluten-free diet adherence in coeliac disease with anxiety and depression. METHODS: A total of 66 coeliac disease patients with state anxiety and current depression were enrolled. Patients were randomized in two groups: in group A psychological support was started at the beginning of gluten-free diet, while group B was free of psychological support. Both groups were followed every 2 weeks for 6 months. State and Trait Anxiety Inventory test Y-1 and the modified Zung self-rating depression scale were administered before (T0) and after 6 months of gluten-free diet (T1). RESULTS: At T1 no difference was found between groups in the percentage of state anxiety, while a significant lower percentage of depressed subjects was found in group A with respect to group B (15.1% vs. 78.8%; P=0.001). In the follow-up period, a significant lower compliance to gluten-free diet was found in group B with respect to group A (39.4% vs. 9.1%; P=0.02). CONCLUSIONS: In coeliac disease patients with affective disorders psychological support seems to be able to reduce depression and to increase gluten-free diet compliance.

Pharmacological approaches to the management of alcohol addiction.

Alcohol abuse and alcoholism represent a world-wide problem, both from a medical and a social point of view. In the past the therapy for patients affected by alcoholism was based mainly on the psychological approach. In recent years the use of pharmacotherapy together with psychosocial interventions have enhanced the percentage of success in maintaining alcoholic patients in remission. The present review discusses the main drugs experimented both in preclinical and clinical studies. Pharmacotherapy of alcohol dependence seems to be effective in both alcohol-related emergencies and prevention relapse. However, pharmacotherapy should not be considered as the only form of treatment but as an integrated part of a multimodal approach including psychological and social support.

[Indications and limitations of endovascular surgery in carotid revascularization]. / Indicazioni e limiti della chirurgia endovascolare nella rivascolarizzazione carotidea.

PURPOSE: Today percutaneous transluminal angioplasty is seldom utilized to treat carotid artery stenosis and the indications and results of this procedure are discordant between the few authors that do it. This leads to caution in selecting PTA as the first choice. Analysing the literature and their own experience, authors describe optimal indications and technique for this procedure. METHODS: Eight patients with stenosis of the common carotid artery and five patients with stenosis of the internal carotid artery were treated with PTA. In the first group five cases were performed in association with a surgical distal revascularization, to obtain a good run-in. In six cases symptomatic restenosis due to intimal hyperplasia were treated. The two remaining cases were relative to complex clinical situations and high operative risk. RESULTS: In eleven patients out of thirteen a good clinical and hemodynamic result was obtained; in one case the carotid artery occluded and in another case a new restenosis occurred. DISCUSSION: PTA has some advantages: low operative trauma, cerebral ischemia short time, possibility to treat inaccessible or hardly accessible lesions. The eventuality of complications is high and for this reason the procedure must be utilised only in selected cases, with prudence and with a team well trained in peripheral angioplasty. CONCLUSION: PTA for carotid artery stenosis today is still an experimental procedure; its value in comparison with carotid endarterectomy has to be proven with well designed clinical randomized trials.

Special considerations concerning regulatory requirements and drug development for peptides and biotech products in the EU.

The marketing authorization for a new medicinal product is based on the scientific assessment of its quality, safety and efficacy. The marketing authorization application (MAA) which covers all the relevant documentation can be filed in the EU via different application procedures. For peptides and biological products special issues have to be taken into consideration during drug development. Due to special production procedures and the complexity of the active substance itself, peptides and biotech products are subject to specific regulatory requirements. This leads to the necessity to discuss the development program of a new peptide or biotech product with the health authorities on a case by case basis. This article will focus on the special regulatory requirements for peptides and biotech products including the registration procedures as well as technical, preclinical and clinical issues.

Conformational studies of heterochiral peptides with diastereoisomeric residues: crystal and molecular structures of linear dipeptides derived from leucine, isoleucine, and allo-isoleucine.

The x-ray diffraction analyses of three N- and C-terminally blocked L,D dipeptides, namely t-Boc-D-Leu-L-Leu-OMe (1), t-Boc-L-Ile-D-aIle-OMe (2), and t-Boc-D-aIle-L-Ile-OMe (3) containing enantiomeric or diastereomeric amino acid residues have been carried out. The structures were determined by direct methods and refined anisotropically to final Rf actors of 0.077, 0.058, and 0.072 for (1), (2), and (3), respectively. Peptides 1-3 all assume a similar U-shaped structure with phi and psi torsion angles corresponding to one of the possible calculated minimum energy regions (regions E and G for L residues, and F*, D* and H* for D residues). The peptide backbones of 1-3 are almost superimposable [provided that the appropriate inversion of the chiral centers of (2) is made]. Side-chain conformations of Leu residues in peptide (1) are g- (tg-) for the L-Leu residue and the mirrored g+ (tg+) for the D-Leu residue; however, in peptides (2) and (3) the conformations of the isoconfigurational side chains of the Ile or allo-Ile residues are (g-t) t and (tg+) t for the L-Ile and the D-allo-Ile moieties, respectively. In all cases, these conformations correspond to the more populated conformers of beta-branched residues statistically found in crystal structures of small peptides. The results seem to indicate that, at least in short peptides with enantiomeric or diastereoisomeric residues, the change in chirality in the main-chain atoms perturbs the backbone conformation to a lesser extent and the side chain conformation to a greater extent.

Nasal mucus clearance in rats: differences with sex and phase of the oestrous cycle.

We studied the changes in airway mucus rheology and clearability, as well as in morphometric indices, between male rats and females in either the oestrous or dioestrous phases of the oestrous cycle. Three-month-old Wistar rats were studied and the phases of the oestrous cycle were determined based on analysis of vaginal smears stained by a modified Shorr's procedure. Nasal mucus samples were analysed by means of magnetic rheometry and determination of in vitro transport rate in the frog palate preparation. In situ clearance on the exposed nasal septum was also determined. The mucociliary velocity in situ was significantly affected by both sex and the oestrous cycle phase. In female rats, dioestrous phase clearance was significantly slower than the oestrous phase one. Clearance in male rats was faster than that of both the phases studied in females. Mucus rigidity of females in the oestrous phase was more rigid than that of females in the dioestrous phase and that of males. Mucus viscosity/elasticity ratio for deformations performed at high frequencies was greater for females in comparison with males. Cough clearability computed on the basis of rheological parameters was predicted to be more favourable in females. There were no significant differences between the three groups in mucociliary clearance in vitro. Morphometric studies of the nasal epithelium showed that epithelial and glandular volumes did not exhibit sex- or oestrous-phase-related differences, but the amount of epithelial acidic glycoproteins was lower in females in the oestrous phase in comparison with males and those in the dioestrous phase, the same trend being observed in the glands of the lamina propria.(ABSTRACT TRUNCATED AT 250 WORDS)

Conformation and structure of linear peptides with regularly alternating L- and D-residues: structure of the blocked hexapeptide tert-butyloxycarbonyl-(D-alloisoleucyl-L-isoleucyl)3 methyl ester monohydrate.

Peptides with a regular sequence of enantiomeric residues (L and D) along the chain have received considerable attention because of their accessibility to unique conformations and because they are model compounds for the naturally occurring peptide gramicidin A, which shows monovalent cation selective transmembrane transport. The solid-state structure of the linear hexapeptide t-Boc-(D-alle-L-Ile)3-OMe has been determined by X-ray diffraction techniques and refined to a final R factor of 0.068. The molecule shows a bent U-shaped conformation stabilized by three intramolecular H-bonds of the N-H...O = C type: a type II beta-bend (4-->1 bend or C10 ring structure) with L-Ile2 and D-aIle3 at positions 2 and 3 of the bend, an alpha-turn (5-->1 bend or C13 ring structure) and a 1-->5 bend or C17 ring structure. The first two 10-membered and 13-membered bends are enclosed in the latter 17-membered hydrogen-bonded ring structure. This structural motif is common to hepta- and octa-peptide cyclic molecules, showing that ring closure is not required to achieve a particular topology in the molecular design of specific bended conformations.

Development of a miniature bioreactor for continuous culture in a space laboratory.

A new type of miniature bioreactor for continuous culture of yeast cells in space laboratories has been developed. Silicon microtechnology has permitted the integration of numerous functions and systems in a volume of 87 x 63 x 63 mm3 and a weight of 610 g. The 100 ml of fresh medium can be delivered at variable flow rates to the cultivation chamber (volume 3 ml) by means of a micropump. The culture is agitated by a magnetic stirrer. Microsensors monitor pH, temperature and redox potential. The decrease of pH occurring during the cultivation of Saccharomyces cerevisiae is compensated electrochemically. A window allows the inspection of the culture status. Samples of up to 1 ml can be drawn through a silicone rubber septum. The data measured by the sensors are transmitted on-line to the ground station during operations in space. The bioreactor had to fulfil several requirements related to the safety regulation of the space agencies. In particular, new materials had to be selected and tested for their biocompatibility. The instrument has now passed all space and biological qualification tests and will be used in an experiment selected by ESA for the International Microgravity Laboratory-2 Mission in Spacelab in July 1994. This paper gives the results of the functional and biological tests and a detailed description of the instrument.

A crystal structure with features of an antiparallel alpha-pleated sheet.

A single-crystal x-ray diffraction analysis of Boc-L-Ala-D-aIle-L-Ile-OMe has been carried out. The analysis has shown (a) that the tripeptide molecules have in part an alpha-extended conformation, the torsion angles of the L-Ala and D-aIle residues being psi 1 = -75.1 degrees and psi 1 = -25.8 degrees and psi 2 = 67.3 degrees and psi 2 = 44.1 degrees, respectively, and (b) that the molecules are organized in rippled planes where they occur in relative antiparallel orientation linked together side by side by H bonds. This molecular organization of the tripeptide corresponds closely to that of an antiparallel alpha-pleated sheet, and likely constitutes the first example of a structure of this kind for which a characterization at the atomic level has been achieved. A molecular dynamics study has shown that the molecular conformation of the tripeptide in the crystalline state is determined primarily by intermolecular interactions.

Conformational characteristics of alternating stereo-co-oligopeptides of D- and L-norleucine: influence of an N-methyl group.

The conformational behavior of members of the series Boc-(L-Nle)m-(D-Nle-L-Nle)(n-m)/2-OMe (m = 0 or 1; n = total number of residues) with n < or = to 12, and of analogs of comparable chain length having a NMe-group on the (n - 3)th residue has been investigated. The study has shown that D,L-alternating oligonorleucines behave very differently from stereo-co-oligopeptides of D-alloisoleucine and L-isoleucine, D- and L-valine, or D- and L-leucine. In particular, it has been found that oligonorleucines do not form beta-helices as do the other oligopeptides. Instead, they form aggregates (very likely of the alpha-pleated sheet type), which are insoluble in common organic solvents even at moderate chain lengths. In marked contrast with this behavior, N-methylated analogs such as those studied, with n from 9 to 15, cannot generate very stable aggregates owing to the N-methyl group, and they prefer to form beta-helices. These beta-helices have been found by solution 1H NMR techniques to be almost exclusively of the types beta 4.4 (single-stranded with about 4.4 residues per turn) and decreases increases beta 5.6 (double-stranded, antiparallel, with about 5.6 residues per turn).

Role of bypass, endarterectomy, extra-anatomic bypass and endovascular surgery in unilateral iliac occlusive disease: a review of 1257 cases.

Some 1257 patients who had undergone revascularization procedures for unilateral iliac occlusions were reviewed retrospectively. A total of 824 patients were operated upon using conventional operations, 165 patients had femorofemoral bypass and 268 were treated using endovascular surgery techniques. Revascularization was performed through an extraperitoneal approach by means of iliac thromboendarterectomy (560) or iliac femoral bypass (264) if there was a total occlusion of either the common or external iliac artery (group 1). A femorofemoral crossover bypass was inserted when the operative risk was considered to be high (group 2). Endovascular procedures (percutaneous transluminal angioplasty 234, laser percutaneous transluminal angioplasty 11, stenting 22, atherectomy one) were used in recent years to treat stenoses or occlusions of 3 cm or less (group 3). The indications for operation were severe claudication in 79.7% in group 1 and 92.6% in group 3, whereas in group 2 66.7% of patients presented with symptoms of more advanced ischaemia. The immediate patency rate was 97.0% after extraperitoneal reconstructive surgery, 96.9% in the femorofemoral group and 92.1% in patients having an endovascular procedure. The operative mortality rate was 0.7, 4.2, and 0.3% for groups 1-3, respectively. The 5-year patency rate, analysed by the life-table method, was 77.9% in group 1, 75.3% in group 2 and 73.7% in group 3 (P = n.s., log rank test). The different revascularization techniques were chosen on the basis of the type of disease present and the patient's general condition. All procedures appeared to be effective when correctly selected.

Intraoperative transluminal angioplasty of recurrent carotid stenosis.

A 61-year-old female presented with symptomatic recurrent left internal carotid stenosis. A method of intraoperative balloon dilatation under protective clamping of the common carotid artery is described.